Provider Demographics
NPI:1932474244
Name:KHAN, DILAWAR (PA)
Entity Type:Individual
Prefix:
First Name:DILAWAR
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 CASTLE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4810
Mailing Address - Country:US
Mailing Address - Phone:718-697-9440
Mailing Address - Fax:718-697-9440
Practice Address - Street 1:1170 CASTLE HILL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4810
Practice Address - Country:US
Practice Address - Phone:718-697-9440
Practice Address - Fax:718-697-9440
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015476363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical